Dear NVOS Members,
The articles contained in this e-newsletter are excerpted from AAOS newsletters and other media sources to help our members stay current on national issues.
The NVOS Staff |
| GAO Report Finds That Orthopaedists Buck The Trend In Self-Referral For PT Services | |
A report from the U.S. Government Accountability Office (GAO)  examines physician self-referral and Medicare spending for physical therapy (PT) services, and finds that self-referring orthopaedic surgeons, on average, referred fewer PT services than non-self-referring orthopaedic surgeons. In contrast, self-referring family practice and internal medicine providers in urban areas generally referred more PT services than their counterparts who did not self-refer. From 2004 to 2010, the report finds that non-self-referred PT services increased at a faster rate than self-referred PT services, and over that time, the number of self-referred PT services per 1,000 Medicare fee-for-service beneficiaries held generally flat, while non-self-referred PT services grew by about 41 percent.
In response to the report, Frederick M. Azar, MD, president of AAOS stated, "Physical therapy outcomes are best when a patient's surgeon and therapist can work closely together. This study confirms the responsible use of in-office ancillary services by orthopaedic surgeons and the importance of maintaining the integration of those services in an orthopaedic surgeon's office to allow for the continuation of care and to provide the best treatment option for patients."
Read more...
Read the GAO summary...
Read the complete report (PDF)...
Read the AAOS statement...
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| Study: Surgeon Attitudes May Affect Reoperation And Readmission Rates |
According to findings published online in the journal Clinical Orthopaedics and Related Research, surgeon attitudes may affect reoperation and readmission rates. The researchers adjusted validated aviation psychology tools used by the U.S. Federal Aviation Administration to measure pilot attitudes by converting aviation scenarios to analogous situations for surgeons. Based on evaluation of 31 surgeons from a single academic program, they found that 9 (24 percent) had elevated levels of macho attitude thought to be hazardous in pilots. In addition, three (8 percent) of those evaluated had potentially harzardous elevated levels of self-confidence, two (5 percent) had high levels of impusivity, one (3 percent) had a high level of anti-authority, and one (3 percent) reported a high level of worry. Overall, 11 surgeons (30 percent) harbored at least one elevated attitude level. Using a regression model, the researchers determined that macho attitude levels predicted 19 percent of the variation in surgeons' rates of readmissions and reoperations. Read the abstract... |
| CMS "Sunshine Act" Portal Now Open For Registration | |
he "Sunshine Act" provisions of the Affordable Care Act require that the U.S. Centers for Medicare & Medicaid Services (CMS) make data on payments and gifts made to physicians and teaching hospitals by medical device and pharmaceutical companies publicly available on a searchable federal database, starting in September 2014. Before the data is publicly posted, physicians and representatives of teaching hospitals will have the opportunity to review it and dispute any inaccurate or incomplete information-but only if they have registered to do so. The registration portal for the CMS "Open Payments" (Sunshine Act) program is now open for user registration.
Read more...
AAOS has set up a web page to help members connect to resources and recent news about the Open Payments system, and strongly encourages members to register at the CMS portal.
Read more...
View the instructional presentation on steps to complete CMS' Enterprise Identity Management system registration.
Read more...
Register now...
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| MGMA Survey Notes Practice Challenges Dealing With ACA Patients | |
A Medical Group Management Association (MGMA) survey of 728 medical groups covering more than 40,000 physicians assesses the impact of Affordable Care Act (ACA) exchanges on those practices during the first 120 days of 2014. The researchers found that more than 80 percent of respondents said their practices are participating with products sold on the ACA exchanges, and that more than 90 percent of those practices have already seen patients covered under the new law. However, 62 percent of respondents reported moderate to extreme difficulty identifying patients with ACA exchange coverage (compared to traditional commercial coverage), and 60 percent stated that factors such as eligibility, cost-sharing, and network coverage were somewhat or much more difficult to determine. Overall, MGMA notes three primary themes, based on the survey responses:
- Practices have experienced difficulty in identifying patients with ACA coverage and obtaining essential information related to that coverage.
- Practices are facing a number of challenges related to patient cost-sharing for ACA insurance exchange coverage.
- Practices have concerns about the impact of the network design of many ACA exchange products.
Read more...
Read the complete report (PDF)...
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OIG Report Finds $6.7 Billion In Improper Medicare Claims Due To Incorrect Coding Or Lack Of Documentation
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A report released by the HHS Office of Inspector General (OIG) finds that Medicare inappropriately paid $6.7 billion for claims for evaluation and management (E/M) services during 2010 due to incorrect coding or lack of documentation. According to OIG, the figure represents 21 percent of Medicare payments for E/M services that year. OIG conducted a medical record review of a random sample of Medicare Part B claims for E/M services, and found that 42 percent of claims for E/M services in 2010 were incorrectly coded, including billing at levels both higher and lower than warranted, and that 19 percent of claims lacked documentation. In addition, OIG found that claims from high-coding physicians were more likely to be incorrectly coded or insufficiently documented than claims from other physicians.
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Thank you to the 2014 Annual Meeting Exhibitors
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2014-2015 Board of Directors
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